■肺康复被认为对接受肺部手术的患者有益,然而它对锻炼能力的具体影响,健康相关生活质量(HRQL),心肺功能需要进一步阐明。本研究旨在使用回顾性倾向评分匹配分析评估PR对接受肺部手术的患者的这些结局的影响。
■我们回顾性分析了2022年1月至2024年5月接受肺手术的420例非小细胞肺癌(NSCLC)患者。其中,84例患者接受PR,而336例未接受PR(对照组)。以1:1的比例进行倾向评分匹配(PSM),每组46名患者。基线特征,肺活量测定,心肺运动试验,呼吸肌力量,HRQL,和肌肉测量在手术前后进行评估。
■PSM之前,组间存在显著差异,PR组年龄较大,肺功能基线不同。PSM之后,小组平衡良好。术后,PR组FEV1/FVC显著改善(64.17%vs.50.87%,p<0.001),FEV1(2.31L/minvs.1.75L/min,p<0.001),和预测的FVC百分比(88.75%与68.30%,p<0.001)。PSM后PR组的心血管反应在运动过程中显示出较低的CI(6.24L/min/m2与7.87L/min/m2,p<0.001)。在锻炼能力方面,PR组的最大WR百分比较高(104.76%vs.90.00%,p=0.017)和峰值VO2(1150.70mL/minvs.1004.74mL/min,p=0.009)。PR还导致术后腿部酸痛减少和CAT总分降低。肌肉测量表明ΔHUESMCSA的减少和PR组中的百分比变化明显较小。
■肺康复能显著提高运动能力,HRQL,肺手术患者的心肺功能。它还可以减轻术后肌肉损失,强调其在肺部手术患者术后管理中的重要性。
UNASSIGNED: Pulmonary rehabilitation is considered beneficial for patients undergoing lung surgery, yet its specific impacts on exercise capacity, health-related quality of life (HRQL), and cardiopulmonary function require further elucidation. This study aimed to evaluate the effect of PR on these outcomes in patients undergoing lung surgery using a retrospective propensity score-matched analysis.
UNASSIGNED: We retrospectively analyzed 420 patients with non-small cell lung cancer (NSCLC) who underwent lung surgery from January 2022 to May 2024. Among these, 84 patients received PR while 336 did not (control group). Propensity score matching (PSM) at a 1:1 ratio yielded 46 patients in each group. Baseline characteristics, spirometry, cardiopulmonary exercise testing, respiratory muscle strength, HRQL, and muscle measurements were assessed pre-and post-surgery.
UNASSIGNED: Before PSM, significant differences existed between groups, with the PR group being older and having different pulmonary function baselines. After PSM, groups were well-balanced. Postoperatively, the PR group showed significant improvements in FEV1/FVC (64.17% vs. 50.87%, p < 0.001), FEV1 (2.31 L/min vs. 1.75 L/min, p < 0.001), and predicted FVC percentage (88.75% vs. 68.30%, p < 0.001). Cardiovascular responses showed a lower CI during exercise in the PR group post-PSM (6.24 L/min/m2 vs. 7.87 L/min/m2, p < 0.001). In terms of exercise capacity, the PR group had higher maximal WR percentage (104.76% vs. 90.00%, p = 0.017) and peak VO2 (1150.70 mL/min vs. 1004.74 mL/min, p = 0.009). PR also resulted in less leg soreness and lower total CAT scores postoperatively. Muscle measurements indicated significantly smaller reductions in ΔHUESMCSA and percentage change in the PR group.
UNASSIGNED: Pulmonary rehabilitation significantly enhances exercise capacity, HRQL, and cardiopulmonary function in patients undergoing lung surgery. It also mitigates postoperative muscle loss, underscoring its importance in the postoperative management of lung surgery patients.